无张力经阴道尿道中段悬吊术治疗女性压力性尿失禁患者的心理变化研究

Psychological changes before and after TVT-O in the treatment of female stress urinary incontinence

目的探讨无张力经阴道尿道中段悬吊术（TVT-O）治疗女性压力性尿失禁的疗效及手术前后心理变化状况。方法对我院泌尿外科2011年11月至2012年3月56例女性压力性尿失禁接受TVT—O术治疗患者进行术前、术后国际尿失禁咨询委员会尿失禁问卷评分（1CIQ-SF）、尿失禁生活质量问卷评分（I-QOL）、1h尿垫试验、手术疗效及焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分，并记录相关数据。结果56例手术均获成功。术后随访3个月时，主观满意率94．6％（53／56），客观有效率9I．1％（51／56），未见尿失禁复发。术前ICIQ—SF为（15．9±3．2）分，术后（8．6±2．7）分（t=6．02，P=0．01）；术前I-QOL（40．3-＋18．9）分，术后（87．6±11．2）分（t=6．81，P=0．01）；术前1h尿垫试验漏尿量（26．7±7．1）g，术后（5．2±2．5）g（t=7．13，P=0．00）；术前SAS评分（59．3±8．3）分，术后（42．6±4．6）分（t=9．15，P=0．01）；术前SDS评分（57．2＋5．6）分，术后（40．2±3．4）分（t=8．63，P=0．01）；手术前后比较差异均有统计学意义。未见严重及长期并发症。结论TVT—O术是治疗女性压力性尿失禁安全有效的方法，同时可有效改善患者的生活质量及心理状态。

Objective To evaluate the treatment results and psychological changes in female pa- tients with stress urinary incontinence （SUI） before and after TVT-O. Methods Fifty-six female patients with SUI underwent TVT-O from Nov. 2011 to Mar. 2012. Preoperative and postoperative International Consultation on Incontinence Questionnaire Short Form （ICIQ-SF） score, Incontinence Quality of Life Questionnaire （I-QOL） score, one hour urine pad test, Self-rating Anxiety Scale （SAS） score, and Self-rating Depression Scale （SDS） score were recorded and analyzed. Results Followed up for 3 months, the subjective satisfactory rate was 94.6% （53/56） , the objective efficiency rate was 91.1% （51/56） , and there was no recurrence in this group. Before operation and 3-month after operation, ICIQ-SF scores were 15.9±3.2 （13-20） and 8.6±2.7 （4-13） , t=6.02, P=0.01; I-QOL scores were 40.3±18.9 （33-62） and 87.6±11.2 （76-102） , t = 6.81, P = 0.01; The urine leakages in one hour urine pad test were 26.7±7.1 （9-51 ）g and 5.2±2.5 （l-8）g, t=7.13, P=0.00; SAS scores were 59.3±8.3 （48-72） and 42.6±4.6 （39-52）, t= 9.15, P=0.01; SDS scores were 57.2±5.6 （49-69） and 40.2±3.4 （36-54） , t=8.63, P=0.01, respectively. No serious and long-term complication occurred. Conclusions TVT-O is a safe and effective treatment option for female SUI. This treatment can improve the quality of life and psychological status of the patients. [